Trocar Support

ABSTRACT

Various trocars and trocar supports are provided for allowing an insufflation port on the trocar to be coupled through the trocar support to an insufflation fluid. In one embodiment, the trocar includes a housing, a cannula extending through the housing, and an insufflation port projecting from the housing. A trocar support is provided having an opening that receives the insufflation port on the housing such that the insufflation port is unobtrusive during use and can be connected and disconnected rapidly.

FIELD

Methods and devices are provided for mounting a trocar on a surgicalrobotic arm.

BACKGROUND

Minimally invasive surgical (MIS) instruments are often preferred overtraditional open surgical devices due to the reduced post-operativerecovery time and minimal scarring. Laparoscopic surgery is one type ofMIS procedure in which one or more small incisions are formed in theabdomen and a trocar is inserted through the incision to form a pathwaythat provides access to the abdominal cavity. The trocar is used tointroduce various instruments and tools into the abdominal cavity, aswell as to provide insufflation to elevate the abdominal wall above theorgans. The instruments and tools can be used to engage and/or treattissue in a number of ways to achieve a diagnostic or therapeuticeffect. Endoscopic surgery is another type of MIS procedure in whichelongate flexible shafts are introduced into the body through a naturalorifice.

Although traditional minimally invasive surgical instruments andtechniques have proven highly effective, newer systems may provide evenfurther advantages. For example, traditional minimally invasive surgicalinstruments often deny the surgeon the flexibility of tool placementfound in open surgery. Difficulty is experienced in approaching thesurgical site with the instruments through the small incisions.Additionally, the added length of typical endoscopic instruments oftenreduces the surgeon's ability to feel forces exerted by tissues andorgans on the end effector. Furthermore, coordination of the movement ofthe end effector of the instrument as viewed in the image on thetelevision monitor with actual end effector movement is particularlydifficult, since the movement as perceived in the image normally doesnot correspond intuitively with the actual end effector movement.Accordingly, lack of intuitive response to surgical instrument movementinput is often experienced. Such a lack of intuitiveness, dexterity, andsensitivity of endoscopic tools has been found to be an impediment inthe increased the use of minimally invasive surgery.

Over the years a variety of minimally invasive robotic systems have beendeveloped to increase surgical dexterity as well as to permit a surgeonto operate on a patient in an intuitive manner. Telesurgery is a generalterm for surgical operations using systems where the surgeon uses someform of remote control, e.g., a servomechanism, or the like, tomanipulate surgical instrument movements, rather than directly holdingand moving the tools by hand. In such a telesurgery system, the surgeonis typically provided with an image of the surgical site on a visualdisplay at a location remote from the patient. The surgeon can typicallyperform the surgical procedure at the location remote from the patientwhilst viewing the end effector movement on the visual display duringthe surgical procedure. While viewing typically a three-dimensionalimage of the surgical site on the visual display, the surgeon performsthe surgical procedures on the patient by manipulating master controldevices at the remote location, which master control devices controlmotion of the remotely controlled instruments.

While significant advances have been made in the field of roboticsurgery, there remains a need for improved methods, systems, and devicesfor use in robotic surgery.

SUMMARY

Various surgical tools and methods are provided for mounting a trocaronto a trocar support.

In one embodiment, a surgical system is provided and includes a trocarhaving a housing and a cannula extending distally from the housing. Thehousing and the cannula can define a tool pathway extending therethroughfor receiving a tool. The housing can include at least one sealconfigured to form a seal across the tool pathway and an insufflationport extending from the housing and in fluid communication with the toolpathway for delivering insufflation therethrough. The system can alsoinclude a carrier configured to be mounted on a distal end of a surgicalrobotic arm. The carrier can include an elongate member having a trocarsupport on a distal end thereof. The trocar support can be configured tosupport the trocar in a substantially fixed position, and at least oneof the elongate member and the trocar support can include an openingformed therein for receiving the insufflation port on the trocar.

In one embodiment, the insufflation port can be concealed by theopening. In certain embodiments, the trocar support can extendsubstantially perpendicular to the elongate member. In other aspects,the opening extends through each of the trocar support and the elongatemember.

In another embodiment, the trocar support can include first and secondmovable arms that are configured to engage the housing of the trocartherebetween. The housing of the trocar can include opposed groovesformed therein for seating the first and second movable arms. Theopening can be positioned between the first and second movable arms andcan be configured to receive the insufflation port on the trocar.

In another embodiment, the opening can be a cut-out formed in a distalend of the elongate member. In other aspects, the insufflation port canextend substantially parallel to the cannula, and the opening can beformed in an upper surface of the trocar support for receiving theinsufflation port. Coupling of the insufflation port to the opening canmate the trocar to the trocar support for holding the trocar in asubstantially fixed position. In other aspects, the insufflation portcan extend substantially perpendicular to the cannula, and the openingcan be formed in a terminal end of the trocar support and is incommunication with a pathway extending through the elongate member. Incertain embodiments, the insufflation port can include a Bal-Seal.

A robotic system is also provided and in one embodiment the system caninclude a trocar having a housing, a cannula extending from the housing,a tool pathway extending through the housing and the cannula, and aninsufflation port projected from the housing and in fluid communicationwith the tool pathway. The system can also include an electromechanicalrobotic arm configured to mount to a support and a carrier mounted to adistal end of the robotic arm. The carrier can include a trocar supporthaving an opening formed therein for receiving at least a portion of theinsufflation port on the trocar.

In one embodiment, the trocar support can include a recess formedtherein for seating the housing on the trocar. In other aspects, thetrocar can be configured to be fixedly mounted to the trocar supportwhen the insufflation port is inserted into the opening. In anotherembodiment, the insufflation port can extend substantially perpendicularto the cannula, and the opening can be formed in an upper surface of thetrocar support for receiving the insufflation port.

Surgical methods are also provided and in one embodiment the method caninclude inserting an insufflation port on a trocar into a bore in atrocar holder mounted on a distal end of a surgical robotic arm,delivering an insufflation fluid through the bore into the insufflationport in the trocar such that the insufflation fluid travels through atool pathway extending through the trocar and is delivered into a bodycavity of a patient, and inserting a tool through the tool pathway ofthe trocar to position an end effector on a distal end of the toolwithin the body cavity.

The insufflation port can be prevented from rotating relative to thetrocar holder. In certain aspects, inserting the insufflation port intothe bore in the trocar holder can mate the trocar to the trocar holder.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 is a perspective view of one embodiment of a surgical roboticsystem that includes a patient-side portion and a user-side portion;

FIG. 2 is a perspective view of one embodiment of a trocar and a trocarsupport;

FIG. 3 is a perspective view of another embodiment of a trocarconnecting to a surgical robotic arm;

FIG. 4 is a cross-sectional view of another embodiment of a trocarconnecting to a surgical robotic arm;

FIG. 5 is a perspective view from behind the surgical robotic arm ofFIG. 4;

FIG. 6 is a perspective view of another embodiment of a trocarconnecting to a surgical robotic arm;

FIG. 7 is a perspective view of the trocar of FIG. 6 connected to thesurgical robotic arm;

FIG. 8 is a cross-sectional view of the trocar and the surgical roboticarm of FIG. 7; and

FIG. 9 is a perspective view of another embodiment of a trocarconnecting to a surgical robotic arm.

DETAILED DESCRIPTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those skilled in the art will understand that the devices andmethods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the present invention is defined solely by the claims. Thefeatures illustrated or described in connection with one exemplaryembodiment may be combined with the features of other embodiments. Suchmodifications and variations are intended to be included within thescope of the present invention.

Further, in the present disclosure, like-named components of theembodiments generally have similar features, and thus within aparticular embodiment each feature of each like-named component is notnecessarily fully elaborated upon. Additionally, to the extent thatlinear or circular dimensions are used in the description of thedisclosed systems, devices, and methods, such dimensions are notintended to limit the types of shapes that can be used in conjunctionwith such systems, devices, and methods. A person skilled in the artwill recognize that an equivalent to such linear and circular dimensionscan easily be determined for any geometric shape. Sizes and shapes ofthe systems and devices, and the components thereof, can depend at leaston the anatomy of the subject in which the systems and devices will beused, the size and shape of components with which the systems anddevices will be used, and the methods and procedures in which thesystems and devices will be used. Additionally, WIPO Patent PublicationNo. WO2014/151621, filed on Mar. 13, 2014 and entitled “HyperdexterousSurgical System,” is incorporated herein by reference.

Various surgical tools and methods are provided for mounting a trocar toa surgical robotic arm. A trocar generally has a housing and a cannulaextending from the housing with a tool pathway extending through thehousing and the cannula for receiving a surgical tool. At least one sealis formed across the tool pathway for sealing the tool pathway when noinstrument is present and when an instrument is present. The housing hasan insufflation port that is in fluid communication with the toolpathway for delivering insufflation therethrough and into a body cavity.

In robotic surgery, a trocar is mounted to a carrier on the distal endof a surgical robotic arm, and the trocar provides a pathway throughtissue for a surgical tool coupled to the robotic arm. Depending on thelocation of an insufflation port, care may be required to avoid damagingthe insufflation port when connecting the trocar to the surgical roboticarm and when connecting insufflation tubing to the stopcock and/or theinsufflation port. In many trocars, the insufflation port has a highprofile and takes up a lot of space during minimally-invasive surgery.As a result, the insufflation port can interfere with positioning of thetrocar, e.g. by hitting the skin surface and/or by hitting other toolsand/or other surgical robotic arms. Thus a trocar support is providedthat is mounted on a distal end of a surgical robotic arm, andinsufflation can be delivered through the trocar support directly to thetrocar to reduce the space requirements of the trocar, and therebyprevent interference during use.

FIG. 1 is a perspective view of one embodiment of a surgical roboticsystem 100 that includes a patient-side portion 102 that is positionedadjacent to a patient 104, and a user-side portion 106 that is located adistance from the patient, either in the same room and/or in a remotelocation. The patient-side portion 102 generally includes one or morerobotic arms 108 and one or more surgical tools and/or tool assemblies110 that are configured to releasably couple to a robotic arm 108. Theuser-side portion 106 generally includes a vision system 112 for viewingthe patient 104 and/or surgical site, and a control system 114 forcontrolling the movement of the robotic arms 108 and each surgical tool110 during a surgical procedure.

The patient-side portion 102 can have a variety of configurations. Asillustrated in FIG. 1, the patient-side portion 102 can couple to anoperating table 116. However, in other embodiments, the patient-sideportion 102 can be mounted to a wall, to the ceiling, to the floor, orto other operating room equipment. Further, while the patient-sideportion 102 is shown as including two robotic arms 108, more or fewerrobotic arms 108 may be included. Furthermore, the patient-side portion102 can include separate robotic arms 108 mounted in various positions,such as relative to the surgical table 116 (as shown in FIG. 1).Alternatively, the patient-side portion 102 can include a singleassembly that includes one or more robotic arms 108 extending therefrom.

The surgical tool 110 includes an elongate shaft 122, an end effector124, and a tool housing 128 coupled to a proximal end of the shaft 122.The shaft 122 can have any of a variety of configurations. In general,the shaft 122 is an elongate member extending distally from the housing128 and having at least one inner lumen extending therethrough. Theshaft 122 is fixed to the housing 128, but in other embodiments theshaft 122 can be releasably coupled to the housing 128 such that theshaft 122 can be interchangeable with other shafts. This may allow asingle housing 128 to be adaptable to various shafts having differentend effectors. The end effector 124 can also have a variety of sizes,shapes, and configurations. The end effector 124 can be configured tomove relative to the shaft 122, e.g., by rotating and/or articulating,to position the end effector 124 at a desired location relative to asurgical site during use of the tool 110. The housing 128 includesvarious components (e.g., gears and/or actuators) configured to controlthe operation various features associated with the end effector 124(e.g., any one or more of clamping, firing, rotation, articulation,energy delivery, etc.). In at least some embodiments, as in thisillustrated embodiment, the surgical tool 110 is configured toreleasably couple to a tool driver 129 mounted on a carrier 130 on thedistal end of the robotic arm 108, and the tool housing 128 can includecoupling features configured to allow the releasable coupling of thetool 110 to the robotic arm 108. As further shown in FIG. 1, the carrier130 can include a trocar or trocar support 132 mounted thereon forreceiving the shaft 122 of the tool 110 therethrough. A person skilledin the art will appreciate that the surgical tool 110 can have any of avariety of configurations, and it can be configured to perform at leastone surgical function. The surgical tool can be, for example, a stapler,a clip applier, forceps, a grasper, a needle driver, scissors, anelectrocautery tool that applies energy, a suction tool, an irrigationtool, an imaging device (e.g., an endoscope or ultrasonic probe), etc.

The control system 114 can have a variety of configurations and can belocated adjacent to the patient (e.g., in the operating room), remotefrom the patient (e.g., in a separate control room), or distributed attwo or more locations (e.g., the operating room and/or separate controlroom(s)). As an example of a distributed system, a dedicated systemcontrol console can be located in the operating room, and a separateconsole can be located in a remote location. The control system 114 caninclude components that enable a user to view a surgical site of thepatient 104 being operated on by the patient-side portion 102 and/or tocontrol one or more parts of the patient-side portion 102 (e.g., toperform a surgical procedure at the surgical site). In some embodiments,the control system 114 can also include one or more manually-operatedinput devices, such as a joystick, exoskeletal glove, a powered andgravity-compensated manipulator, or the like. The one or more inputdevices can control teleoperated motors which, in turn, control themovement of the surgical system, including the robotic arms 108 andsurgical tools 110.

As indicated above, in an exemplary embodiment a trocar is provided witha housing and a cannula having a tool pathway extending therethrough toreceive an elongate shaft and an end effector of a surgical tool, suchas the surgical tool 110. A variety of different mechanisms can be usedto connect an insufflation pathway to the trocar such that theinsufflation pathway and/or any stopcock are unobtrusive during use andcan be connected and disconnected rapidly. FIG. 2 illustrates oneembodiment of a trocar 200 with a housing 202 and a cannula 204. A toolpathway extends through an opening 206 in the housing 202 and throughthe cannula 204 along a longitudinal axis A1. To facilitate viewingwithin a body cavity, insufflation fluid can be introduced through aninsufflation port 208 in the trocar 200 to inflate the body cavity. Theinsufflation port 208 extends outward from a sidewall of the housing,substantially perpendicular to the axis A1. The insufflation port can bein the form of a hollow protrusion or tube, and it can differ from priorart insufflation ports in that no stopcock is required. The insufflationport 208 is in fluid communication with the pathway extending throughthe trocar 200 and into a body cavity of a patient, such thatinsufflation can be delivered into the port and through the trocarcannula into a body cavity.

In order to prevent leakage from the trocar 200 when filling the bodycavity with insufflation fluid, the trocar can include one or more sealsextending across the tool pathway. For example, the trocar can include azero-closure valve, which seals the tool pathway when no tool present,and/or an instrument seal, which forms a seal around the shaft of aninstrument passed therethrough. A person skilled in the art willappreciate that any seal(s) known in the art can be used to form a sealacross the tool pathway in the trocar.

As further shown in FIG. 2, a robotic arm 220 is provided that has atrocar support 222 mounted on its distal end that receives and providessupport to the trocar 200. In general, the robotic arm 220 has agenerally elongate configuration and the trocar support extendssubstantially perpendicular from a distal end of the robotic arm 220. Invarious embodiments, the trocar support can be pivotably connected tothe robotic arm and can pivot about the arm. The trocar support 222 hasan opening 224 formed therein and a gap 226 extending into the opening224. The gap 226 is wide enough to allow a trocar cannula 204 to passtherethrough, and the opening 224 is large enough to allow thedistalmost end of the trocar housing 202 to be seated therein withoutpassing therethrough. The trocar support 222 forms a cradle 222 c aroundthe opening 224, that functions to receive and cradle the bottom surfaceof the trocar housing while allowing passage of the cannula into thebody cavity of a patient while. The robotic arm 220 has an insufflationpathway formed therein and extending along any portion of the lengththereof. The pathway can extend across the trocar support 222,terminating at a location proximally adjacent to the opening 224 in thetrocar support 222. In the illustrated embodiment, an insufflationtubing 228 extends through the insufflation pathway, however in otheraspects the insufflation pathway can function to directly transportinsufflation fluid. The insufflation tubing 228 includes a port 230 on aterminal end thereof that is seated in a bore 232 formed in the trocarsupport 222. The port 230 can be positioned to couple with the port 208on a trocar when a trocar is seated in the opening 224.

In use, when port 208 is connected to port 230, the insufflation tubing228 can deliver an insufflation fluid therethrough and into the trocarfor delivery to a body cavity. When the trocar 200 is placed in thetrocar support 222, the insufflation port 208 can extend toward or intothe bore 232, preventing port 208, port 230, and the insufflation tubing228 from interfering with use of the device. In some embodiments,turning on and off insufflation (e.g. flow control) can be accomplishedvia a flow control valve placed anywhere in line with the tubing 228routed through or along the robotic arm 220. User control of the flowcontrol value can be accomplished either manually (e.g. mechanically atthe source) and/or remotely (e.g. automatic activation) via a userinterface, such as the user-side portion 106 or other user consoles. Inother embodiments, the insufflation port can be concealed in the trocarby a hinged insufflation lock. As the trocar is connected to a trocarsupport on a robotic arm, the hinged insufflation lock can rotate toexpose the insufflation port on the trocar to the correspondinginsufflation connection on the robotic arm. Alternatively aninsufflation port can extend out of a bottom of the trocar.

FIG. 3 illustrates another embodiment of a trocar 300 similar to thetrocar 200 of FIG. 2. The trocar 300 has a housing 302 and a cannula 304with a tool pathway running therethrough and at least one seal extendingthereacross, as discussed above. The proximal end of the housing 302includes an opening 306 for receiving a surgical tool, and aninsufflation port 308 extends outward from a sidewall of the housing302. The port 308 is in fluid communication with the tool pathwayextending through the trocar 300 such that fluid can be deliveredthrough the port 308 and into a body cavity of a patient. FIG. 3 furtherillustrates a trocar support 322 that can be formed on or mounted on adistal end of a robotic arm. In this embodiment, the trocar support 322has a generally U-shaped configuration with a first end 322 a thatmounts to the robotic arm and a second opposite end 322 b that isconfigured to receive the trocar therein. As shown, the first end 322 ahas an opening 332 formed therein with an insufflation tubing 328extending through the opening 332. The insufflation tubing 328 isconfigured to connect to the port 308 on the trocar 300. The second end322 b of the trocar support 322 opposed arms 323 that define an openingtherebetween for receiving the trocar, and the inner surface of the arms323 define a cradle 322 c therein for engaging the trocar housing. Thearms 323 of the trocar support 322 can be biased radially inward by aspring mechanism in the trocar support 322. The arms 323 can be movedradially outward by overcoming the spring bias to allow the trocar 300to be inserted into the cradle 322 c. When the arms are released, thespring bias causes the arms to close around the trocar support 322 andgrip the trocar 300 within the trocar support 322. As shown in FIG. 3,the trocar housing can include at least one groove 305 formed thereinfor seating the arms so as to prevent sliding of the trocar housing 302relative to the trocar support 322.

In use, when the insufflation tubing 328 is connected to the port 308and the trocar 300 is placed in the trocar support 322, the insufflationtubing 328 and the port 308 will be concealed within the trocar support322, and insufflation can be provided to a body cavity through theinsufflation tubing 328 and the trocar. In some embodiments,insufflation flow can be controlled by a flow control valve placedanywhere in line with the tubing 328 routed through or along the roboticarm 220. User control of the flow control value can be accomplishedeither manually (e.g. mechanically at the source) and/or remotely (e.g.automatic activation) via a user interface, such as the user-sideportion 106 or other user consoles.

FIGS. 4 and 5 illustrate another embodiment of a trocar 400 that issimilar to trocar 200 and that includes a housing 402 and a cannula 404as described above. The trocar 400 is configured to mount to a trocarsupport 422 formed on or mounted on a distal end of a carrier 420, suchas a robotic arm. In this embodiment, the carrier 420 is in the form ofa generally elongate body having a cut-out or opening 440 formed in adistal end thereof for receiving an insufflation tubing 428 or forreceiving a port on the trocar 400. The support 422 can extend outwardfrom the carrier 420, e.g., substantially perpendicular to the carrier,and it can be configured to receive the trocar 400 therethrough, e.g.,using techniques discussed above. The port or insufflation tubing 428can be coupled to an insufflation source so as to allow an insufflationfluid to be delivered into the trocar and into a body cavity of apatient. With the port or tubing positioned within the cut-out, the portwill remain out of the way and thus will not interfere with use of thetrocar during robotic surgery.

FIGS. 6-8 illustrate another embodiment of a trocar 500. As shown, thetrocar 500 has a housing 502 and a cannula 504 with a tool pathwayextending therethrough and having at least one seal extendingthereacross, as discussed above. In this embodiment, the housing 502 hasa top portion 502 t and a side portion 502 s that connect to one anotherat an approximate 90 degree angle, forming an approximate L shape. Theside portion 502 s is hemi-cylindrical in shape and has a flat surfaceformed on one side thereof and positioned underneath the top portion 502t. An opening 506 is formed on a top surface of the top portion 502 t ofthe trocar housing 502 for receiving a surgical tool, and the toolpathway extends therethrough. As shown, an insufflation port 508 extendsdistally from a bottom surface of the top portion 502 t and extendssubstantially parallel to the side portion 502 s. The insufflation port508 is part of a sealing mechanism, such as a Bal-Seal® mechanism 510,having an approximately semi-circular shape and having springs that areconfigured to create a seal. O-rings can be incorporated to assist inthe sealing while the Bal-Seal mechanism 510 facilitates a secure butreleasable connection between the trocar 500 and a carrier 520. Theinsufflation port 508 is in fluid communication with an insufflationpathway that extends through the top portion 502 t and connects with thetool pathway so as to allow insufflation to be delivered through thecannula 504 and into a body cavity. Alignment pins 512 on the trocarhousing 502 can extend distally from the bottom surface of the topportion 502 t for aligning the trocar housing 502 with the trocarsupport, discussed below. The alignment pins 512 can extendsubstantially parallel to the port 508. Alignment ledges 505 can beformed along the flat surface of the side portion 502 s of the housing502 for further facilitating alignment with the trocar support.

The carrier 520 can be formed on or mounted on a distal end of a roboticarm (not shown), and the carrier 520 can include a trocar support 522that extends therefrom such that the carrier and the trocar support arein the shape of an L. The illustrated trocar support 522 has a flat, topsurface that forms a ledge. The opening 506 can include a chamferedlead-in to help guide robotic tools during installation. An opening 524is formed in the top surface of the trocar support 522. The opening canhave a shape that corresponds to the shape of the B al-Seal mechanism510 for seating the Bal-Seal mechanism 510 therein. An insufflationpathway 528 extends from the opening 524 through the trocar support 522,and it extends upward through the carrier 520 to mate with aninsufflation source. An insufflation tubing 528 a can be disposed withinthe insufflation pathway 528, or the pathway 528 can function totransport an insufflation fluid directly without the using of tubing 528a. A bottom of the opening 524 in the trocar support 522 can terminateat a port 530 that couples to the insufflation tubing 528 a. Alignmentopenings 514 are formed on the top surface of the trocar support 522,and alignment grooves 515 extend along and are recessed within a frontsurface of the trocar support 522. In some embodiments, insufflationflow can be controlled by a flow control valve placed anywhere in linewith tubing 528 a. User control of the flow control value can beaccomplished either manually (e.g. mechanically at the source) and/orremotely (e.g. automatic activation) via a user interface, such as theuser-side portion 106 or other user consoles.

In use, as the trocar 500 is inserted onto the trocar support 522, thetop portion 502 t of the trocar 500 is rested on top of the ledge-liketop surface of the trocar support 522, and the flat surface of the sideportion 502 s of the trocar 500 rests against the front surface of thetrocar support 522. The cannula 504 runs alongside the trocar support522, as illustrated in FIGS. 7 and 8. The alignment pins 512 of thetrocar 500 are inserted into the alignment openings 514 on the trocarsupport 522, and the alignment ledges 505 of the trocar 500 are insertedinto the alignment grooves 515 of the trocar support 522 to ensureproper alignment of the trocar and to prevent or reduce radial movement.The B al-Seal mechanism 510 of the trocar 500 is inserted into thecorresponding opening 524 on the trocar support 522, forming a sealbetween the pathway extending through the trocar 500 and theinsufflation pathway 528 extending through the support 522 and carrier520. The port 508 on the trocar 500 engages and connects to the port 530of the insufflation pathway 528 running through the support 522, thusallowing an insufflation fluid to be delivered therethrough and into abody cavity of a patient. As the trocar 500 is attached to the trocarsupport 522, the insufflation pathway is connected automatically anddoes not require a manual connection. A stopcock 550 can extend from anupper surface of the trocar 500, thus allow for easy access to thestopcock 550 while still maintaining a nonobtrusive design andprotecting the insufflation pathway.

Another embodiment of a trocar 600 and trocar support 622 is illustratedin FIG. 9. The trocar 600 is similar to the trocar 500 in FIGS. 6-8 anduses an O-ring or gasket to seal and Bal-Seal technology configured tofacilitate a releasable mechanical connection. In various embodiments,an O-ring or gasket can be placed in front of and/or behind the Bal-Sealmechanism to create a seal. The trocar 600 has a housing 602 and acannula 604, and a tool pathway runs therethrough with at least one sealextending thereacross. An opening 606 is formed in a top surface of thehousing 602 for receiving a surgical tool. The housing 602 and thecannula 604 together are generally L-shaped, with the cannula 604 beingpositioned laterally outward from a center of the housing. The housing602 has a front surface 602 a and a back surface 602 b. The frontsurface 602 a has a hemi-cylindrical shape, and the back surface 602 bis generally flat. An insufflation port 608 extends from the backsurface 602 b of the housing 602. The insufflation port 608 is in fluidcommunication with a first insufflation pathway in the form of a lumenextending through the trocar housing 602 and connecting to the toolpathway so as to allow an insufflation fluid to be delivered into a bodycavity of a patient. The insufflation port 608 can include a B al-Sealmechanism 610 that is configured with O-ring(s) and/or gasket(s) tocreate a releasable coupling and/or a seal when mated to the trocarsupport. Alignment pins 612 on the trocar housing 602 can extend fromthe back surface 602 b of the housing 602 parallel with the port 608.

The trocar support 622 can be disposed on a distal end of a carrier 620formed on or coupled to a robotic arm. The trocar support 622 can extendgenerally perpendicular to the carrier 620 to form an L shapedconstruct. The illustrated trocar support 622 has a front surface 622 awith alignment openings 614 formed therein. A receiving opening 624 isformed on the front surface 622 a, and an insufflation pathway 628extends through the carrier 620 for receiving an insufflation tubing orfor directly receiving an insufflation fluid therethrough.

As the trocar 600 is connected to the trocar support 622, the alignmentpins 612 can be inserted into corresponding alignment openings 614 andthe Bal-Seal mechanism 610 can be inserted into the receiving opening624 on the trocar support 622. As the Bal-Seal mechanism 610 is insertedinto the opening 624, an insufflation pathway is connected between thecarrier 620 and the trocar 600.

As will be appreciated by a person skilled in the art, electroniccommunication between various components of a robotic surgical systemcan be wired or wireless. A person skilled in the art will alsoappreciate that all electronic communication in the system can be wired,all electronic communication in the system can be wireless, or someportions of the system can be in wired communication and other portionsof the system can be in wireless communication.

The systems, devices, and methods disclosed herein can be implementedusing one or more computer systems, which may also be referred to hereinas digital data processing systems and programmable systems.

A computer system can also include any of a variety of other softwareand/or hardware components, including by way of non-limiting example,operating systems and database management systems. Although an exemplarycomputer system is depicted and described herein, it will be appreciatedthat this is for sake of generality and convenience. In otherembodiments, the computer system may differ in architecture andoperation from that shown and described here.

Preferably, components of the invention described herein will beprocessed before use. First, a new or used instrument is obtained and ifnecessary cleaned. The instrument can then be sterilized. In onesterilization technique, the instrument is placed in a closed and sealedcontainer, such as a plastic or TYVEK bag. The container and instrumentare then placed in a field of radiation that can penetrate thecontainer, such as gamma radiation, x-rays, or high energy electrons.The radiation kills bacteria on the instrument and in the container. Thesterilized instrument can then be stored in the sterile container. Thesealed container keeps the instrument sterile until it is opened in themedical facility.

Typically, the device is sterilized. This can be done by any number ofways known to those skilled in the art including beta or gammaradiation, ethylene oxide, steam, and a liquid bath (e.g., cold soak).An exemplary embodiment of sterilizing a device including internalcircuitry is described in more detail in U.S. Pat. No. 8,114,345 filedFeb. 8, 2008 and entitled “System And Method Of Sterilizing AnImplantable Medical Device.” It is preferred that device, if implanted,is hermetically sealed. This can be done by any number of ways known tothose skilled in the art.

One skilled in the art will appreciate further features and advantagesof the invention based on the above-described embodiments. Accordingly,the invention is not to be limited by what has been particularly shownand described, except as indicated by the appended claims. Allpublications and references cited herein are expressly incorporatedherein by reference in their entirety.

What is claimed is:
 1. A surgical system, comprising: a trocar having ahousing and a cannula extending distally from the housing, the housingand the cannula defining a tool pathway extending therethrough forreceiving a tool, the housing including at least one seal configured toform a seal across the tool pathway and an insufflation port extendingfrom the housing and in fluid communication with the tool pathway fordelivering insufflation therethrough; and a carrier configured to bemounted on a distal end of a surgical robotic arm, the carrier includingan elongate member having a trocar support on a distal end thereof, thetrocar support being configured to support the trocar in a substantiallyfixed position, and at least one of the elongate member and the trocarsupport including an opening formed therein for receiving theinsufflation port on the trocar.
 2. The system of claim 1, wherein theinsufflation port is concealed by the opening.
 3. The system of claim 1,wherein the trocar support extends substantially perpendicular to theelongate member.
 4. The system of claim 1, wherein the opening extendsthrough each of the trocar support and the elongate member.
 5. Thesystem of claim 1, wherein the trocar support includes first and secondmovable arms that are configured to engage the housing of the trocartherebetween.
 6. The system of claim 5, wherein the housing of thetrocar includes opposed grooves formed therein for seating the first andsecond movable arms.
 7. The system of claim 5, wherein the opening ispositioned between the first and second movable arms and is configuredto receive the insufflation port on the trocar.
 8. The system of claim1, wherein the opening comprises a cut-out formed in a distal end of theelongate member.
 9. The system of claim 1, wherein the insufflation portextends substantially parallel to the cannula, and wherein the openingis formed in an upper surface of the trocar support for receiving theinsufflation port.
 10. The system of claim 1, wherein coupling of theinsufflation port to the opening mates the trocar to the trocar supportfor holding the trocar in a substantially fixed position.
 11. The systemof claim 1, wherein the insufflation port extends substantiallyperpendicular to the cannula, and wherein the opening is formed in aterminal end of the trocar support and is in communication with apathway extending through the elongate member.
 12. The system of claim1, wherein the insufflation port includes a Bal-Seal.
 13. A roboticsystem, comprising: a trocar having a housing, a cannula extending fromthe housing, a tool pathway extending through the housing and thecannula, and an insufflation port projected from the housing and influid communication with the tool pathway; an electromechanical roboticarm configured to mount to a support; and a carrier mounted to a distalend of the robotic arm, the carrier including a trocar support having anopening formed therein for receiving at least a portion of theinsufflation port on the trocar.
 14. The robotic system of claim 13,wherein the trocar support includes a recess formed therein for seatingthe housing on the trocar.
 15. The robotic system of claim 13, whereinthe trocar is configured to be fixedly mounted to the trocar supportwhen the insufflation port is inserted into the opening.
 16. The roboticsystem of claim 13, wherein the insufflation port extends substantiallyperpendicular to the cannula, and the opening is formed in an uppersurface of the trocar support for receiving the insufflation port.
 17. Asurgical method, comprising: inserting an insufflation port on a trocarinto a bore in a trocar holder mounted on a distal end of a surgicalrobotic arm; and delivering an insufflation fluid through the bore intothe insufflation port in the trocar such that the insufflation fluidtravels through a tool pathway extending through the trocar and isdelivered into a body cavity of a patient; and inserting a tool throughthe tool pathway of the trocar to position an end effector on a distalend of the tool within the body cavity.
 18. The method of claim 17,wherein the insufflation port is prevented from rotating relative to thetrocar holder.
 19. The method of claim 17, wherein inserting theinsufflation port into the bore in the trocar holder mates the trocar tothe trocar holder.